Rheumatoid Arthritis

Rheumatoid Arthritis

from ACP Medicine

Best Tests

Physical exam of jointsSwelling, warmth, tenderness, limited range of motionX-rayOften cannot detect early pathologyUseful for following disease progressionShows bone erosions at margins of the jointShows cystlike radiolucencies in larger jointsMRICan detect pannus invasion of jointsBest image for large jointsNo specific laboratory testsSerologyMild normochromic, normocytic anemia and elevated platelet count usually present; leukocyte count generally normalESR and C-reactive protein level are usually elevated in active RA and are useful in monitoring disease activity and response to therapySerum chemistry usually normal80%-85% of RA patients are seropositive for rheumatoid factor (RF), but specificity for RA is lowCCP antibodies more specific (85%-90%) but less sensitive (50%-60%) for RA than RF; could be a useful diagnostic test in some casesSynovial fluid usually straw colored and mildly turbid; rarely diagnostic

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